National Provider Identifier Database

PRISCILLA ROTH WALL, PhD – NPI #1457386963
Clinical

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth — one that is broadly inclusive of severe psychopathology — and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.


Contact Information

PRISCILLA ROTH WALL, PhD
3751 N BUTLER AVE STE 115
FARMINGTON, NM87401-6425
Phone: 505-787-2640
Fax: 505-787-2789
Website:
Specialty Taxonomy Code
* Clinical 103TC0700X
Clinical Child & Adolescent 103TC2200X
Intellectual & Developmental Disabilities 103TM1800X

* Indicates primary specialty

NPI Profile & details for PRISCILLA ROTH WALL

NPI Number 1457386963
Credentials PhD
Entity Individual
Enumeration date 07/12/2006
Last updated 04/30/2020 - About 6 years ago
Sole proprietor1 Yes
Identifiers
  • NM License #: PSY1470
  • NM Medicaid: 16970748
  • NM Other: 73763700 MAGELLAN
  • NM Other: PSY1470 PSYCHOLOGY LICENSE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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